Provider Demographics
NPI:1932679974
Name:ABLAZE HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:ABLAZE HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:COSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-444-1231
Mailing Address - Street 1:PO BOX 42158
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46242-0158
Mailing Address - Country:US
Mailing Address - Phone:317-444-1231
Mailing Address - Fax:317-243-2709
Practice Address - Street 1:5610 CRAWFORDSVILLE RD STE 2303
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46224-3700
Practice Address - Country:US
Practice Address - Phone:317-444-1231
Practice Address - Fax:317-243-2709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health